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Home My WebLink AboutPermit Mechanical 2003-9-22 "'" ;.[~;.-- - ~.. ~. .., CITY OF SPRIl'n..-NJi.LD Building/Combination Permit PERMIT NO: COM2003-00941 ISSUED: 09/22/2003 APPLIED: 09/22/2003 EXPIRES: 03/22/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2039 FIRTH AVE ASSESSOR'S PARCEL NO.: 1703251206800 Springfield TYPE OF WORK: Mechanical Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Install gas line and appliance vent Owner: DENNIS RUARK Address: 2039 FIRTH AVE SPRINGFIELD OR 97478 Phone Number: 541-935-4768 Contractor Type Mechanical Contractor MIDGLEY'S I CONTRACTOR INFORMATION I License 019364 Expiration Date 11/20/2003 Phone 343-1131 # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 BUILDING INFORMATION' 0\.1\0 Q\.Ilfes'1 "\ # of S!oP.~~aon laW fe fegon U\III '1Lot Size: t:1'\I1~!ghj'.,!f'~\r;.uJt9~e.tle 0 afe set \O"S.q Ft 1st Floor: ;..11 ?:YJl~ of;He~t:TtlOse f\.lleS f\ 95Z-ors.q Ft 2nd Floor: \OIIOW fWater(TYpe: ItlfOUgtl OP\ he f\.lleSSq Ft Basement: \'Io\i\ica\~~~~(fyp,!;1~~ copies 0\ \ leptlonSq Ft Garage/Carport in O;..f\ Ene~gy.:.~atli:\aln ole', \tle \e ilica\iSq,Ft Other: 0090. '(0\.1 ~~ centef. ~\'I u\iliW \'10\ Impervious Surface Area: ,,~....n hi _..onon .....nAJ1.\. Vlhr SETBACKS I DEY.EII0PMENT.INEORMATION I ~- REQUIRED PARKING Frontyard Setback: Side I Setback: Side 2 Setback: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: Total: Handicapped: Compact: Rearyard Setback: Solar Setbacks: % of Lot Coverage: Nnl\CE~ _ ~ .. I ~)(PIRE If lH~ ~O~~ IPUBLIlrltiM~:Q&~~~1i\ 1 HIS I't~~IOLlf~t ~u ""~ \ . 0 \'~. ABJl.NOO,,~ COMMENCED 0" . Sfifewalk Type: AN'i '\80 OA'i PERIOD. DownspoutslDrains: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Paeelof2 . . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2003-00941 ISSUED: 09/22/2003 APPLIED: 09/22/2003 EXPIRES: 03/22/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I F~~s tiWU Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcbarge Appliance Vent Gas Outlets 1-4 Minimum/Adjustment Mechanical Amount Paid Date Paid Receipt Number $10.00 $4.50 $3.15 $6.00 $4.00 $35.00 9/22/03 9/22/03 9/22/03 9/22/03 9/22/03 9/22/03 1200200000000002179 1200200000000002179 1200200000000002179 1200200000000002179 1200200000000002179 1200200000000002179 Total Amount Paid $62.65 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. I, Reouir~d InsnectinnsJ 1 Rough Mechanical: Prior to Cover 2 Final Mechanical: When all mechanical work is complete. 3 Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing. Presure test done at this point. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all tim;;;;:;A--- $~A~ . ~ Owner or Contractors Signature Date Paee 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00941 COM2003-00941 COM2003-00941 COM2003-0094I COM2003-0094I COM2003-0094I Payments: Type of Payment Check Paid By MIDGLEYS ."~ """"~ "".!>n,""'''''''' ".J,." '.,'". Wi" , :;; " ., ,.", '~,...~"~..ii: 1 _,..,"., ~_) " .1 Receipt #: 1200200000000002179 Description + 7% State Surcharge + 10% Administrative Fee Appliance Vent Gas Outlets 1-4 Minimum/Adjustment Mechanical -Mechanical Issuance Fee- Received By djb (;heck Number Batch Number Authorization Number City 'of Springfield Official Receipt Development Services Department .; Public Works Department Date: 09/22/2003 11:49:43AM Amount Paid Item Total: 3,15 4,50 6,00 4,00 35,00 10,00 $6Z.65 How Received In Person Payment Total: Amount Paid . $62,65 $6Z.65 .